Nothing conditions people’s lives as much as health—or, rather, the lack of it. The ability to work, produce, create wealth and raise a family is directly related to health. It is difficult—very difficult—to develop a community or a country when the government, education system or infrastructure is precarious; it is impossible, however, when precariousness is the defining characteristic of the population’s health. This universal reality is even more relevant in poor countries. More illness means more poverty and more poverty means more illness. By breaking this cycle, we could eliminate one of the most powerful generators of inequality, and yet we find it very difficult to do just that. We resign ourselves to health as if it were a congenital defect. Poor people die; rich people die, too, but much later.
Perhaps this is why three of the eight Millennium Development Goals (MDGs)—defined by the international community at the turn of the century to address the staggering problem of global inequality—are directly related to the health of the world’s most disadvantaged populations. Have they worked? As goals, no: none of the MDGs will be met by the 2015 deadline. However, the fact that they were set as targets has been positive on the whole. They have served as a worldwide incentive to mobilise resources, propose changes, generate initiatives and create responsive organisations that are better equipped to address epidemics such as AIDS, which just a decade ago threatened to decimate an entire generation of Africans.
Of course, there’s some good news. The incidence of malaria, for example, which still kills more than half a million people each year, has fallen by nearly 30%, and millions of patients with tuberculosis or AIDS have survived thanks to access to new treatments. But that’s just part of the story. What about the many other diseases that were neglected by the MDGs? Amidst efforts to define new goals for the future, Cambodian activists have coined a powerful slogan: “I Wish I Had AIDS.” This rallying cry recognises the relative success that has been attained in AIDS treatment while reminding us that, although life has improved for some, the world as a whole is not faring well.
We have clearly made great progress, but it is not enough. We have not managed to close the vast equality gap that still sentences much of humanity to an early, avoidable death or, at most, a life marred by illness. As the MDG deadline draws near, the international community is discussing a new commitment to address unfinished business: guaranteeing universal health care coverage. It may end up being just a slogan. However, as was the case with AIDS, defining a specific commitment could mean the difference between failure and a path towards a more balanced world. But that’s a topic for another article.
[A version of this post was published simultaneously in the Planeta Futuro supplement of El País.]